The Role of Vitamin D in Controlling and Managing Glycaemic Control in Patients with Type 2 Diabetes (D4D)

Yu, Xuefei (Fay)

The Role of Vitamin D in Controlling and Managing Glycaemic Control in Patients with Type 2 Diabetes (D4D)

Yu, Xuefei (Fay)

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Publication Type:: Thesis
Issue Date:: 2021

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Field	Value	Language
dc.contributor.author	Yu, Xuefei (Fay)
dc.date.accessioned	2022-01-18T02:00:47Z
dc.date.available	2022-01-18T02:00:47Z
dc.date.issued	2021
dc.identifier.uri	http://hdl.handle.net/10453/153259
dc.description	University of Technology Sydney. Faculty of Science.	en_US.UTF-8
dc.description.abstract	𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱: There is growing evidence indicating the link between serum 25-hydroxy-vitamin D (25(OH)D) level and Type 2 Diabetes Mellitus (T2DM). Many large cohort observational studies have confirmed an inverse association between serum 25(OH)D level and T2DM risks, while Randomised Control Trials (RCTs) have presented inconsistent results. It was therefore decided to conduct a literature review of current RCTs to identify limitations, design and conduct a more rigorous RCT, i.e. D4D trial, to evaluate the association between serum 25(OH)D level and T2DM. 𝗠𝗲𝘁𝗵𝗼𝗱: D4D trial was a long-term, multi-centre, single-blind, four-arm parallel-group trial. Eligible participants were randomised to receive vitamin D from interventions: 1) 10-15 µg/day (400-600 IU/day) from food, 2) 12.5 µg/day (500 IU/day) from sunlight exposure, 3) 12.5 µg/day (500 IU/day) from supplements or 4) waitlist without intervention, for nine months. Serum 25(OH)D level, HbA1c and lipids levels were measured at baseline, 3rd, and 9th month after the intervention. 𝗥𝗲𝘀𝘂𝗹𝘁𝘀: 60 participants were recruited in the D4D trial, with 15 participants per intervention group. Results suggested serum 25(OH)D was inversely associated with HbA1c level but was not statistically significant. Detailed results as following: 1) Serum 25(OH)D level in Diet group at 9th month was significantly increased compared to Waitlist group (p=0.0068) and Supplement group (p=0.0392), 2) Serum 25(OH)D in Diet group at 9th month was significantly increased compared to baseline (p=0.0166) and 3rd month (p=0.0268); 3) Serum 25(OH)D level in Sun exposure group at 3rd month and in Supplement group at 9th month was significantly increased compared to their baseline (p=0.0361 and p=0.0319); 4) HbA1c level in Diet group (p=0.0279) at 9th month was significantly reduced compared to Waitlist group, 5) HbA1c level in Diet group (p=0.0039) and Supplement Group (p=0.0332) at 3rd month and Diet group (p=0.0299) at 9th month also presented significant decreases compared to baseline, 6) Lipids levels were not significantly changed by the interventions. 𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻: Dietary vitamin D is the most effective source to increase Serum 25(OH)D levels and improve glycaemic control among T2DM patients. Vitamin D from sun and supplements requires a large dosage and a medium to long intervention time to show the effects. Future well-designed clinical trials should assess the vitamin D from natural lifestyle interventions to distinguish vitamin D’s effect on glycaemic control from the confounding factors and generate feasible and patient-oriented suggestions.	en_US.UTF-8
dc.format	Thesis (PhD)
dc.language.iso	en_US	en_US.UTF-8
dc.relation	https://opus.lib.uts.edu.au/bitstream/10453/153259/2/02whole.pdf
dc.rights	The author owns the copyright in this thesis including all reproduction and reuse rights for the work. The work may not be altered without the permission of the copyright owner. Attribution is essential when quoting or paraphrasing from this thesis.
dc.rights	au.edu.uts.lib/ppc
dc.rights	info:eu-repo/semantics/openAccess
dc.title	The Role of Vitamin D in Controlling and Managing Glycaemic Control in Patients with Type 2 Diabetes (D4D)	en_US.UTF-8
dc.type	Thesis
utslib.copyright.status	open_access	*

Abstract:

𝗕𝗮𝗰𝗸𝗴𝗿𝗼𝘂𝗻𝗱: There is growing evidence indicating the link between serum 25-hydroxy-vitamin D (25(OH)D) level and Type 2 Diabetes Mellitus (T2DM). Many large cohort observational studies have confirmed an inverse association between serum 25(OH)D level and T2DM risks, while Randomised Control Trials (RCTs) have presented inconsistent results. It was therefore decided to conduct a literature review of current RCTs to identify limitations, design and conduct a more rigorous RCT, i.e. D4D trial, to evaluate the association between serum 25(OH)D level and T2DM. 𝗠𝗲𝘁𝗵𝗼𝗱: D4D trial was a long-term, multi-centre, single-blind, four-arm parallel-group trial. Eligible participants were randomised to receive vitamin D from interventions: 1) 10-15 µg/day (400-600 IU/day) from food, 2) 12.5 µg/day (500 IU/day) from sunlight exposure, 3) 12.5 µg/day (500 IU/day) from supplements or 4) waitlist without intervention, for nine months. Serum 25(OH)D level, HbA1c and lipids levels were measured at baseline, 3rd, and 9th month after the intervention. 𝗥𝗲𝘀𝘂𝗹𝘁𝘀: 60 participants were recruited in the D4D trial, with 15 participants per intervention group. Results suggested serum 25(OH)D was inversely associated with HbA1c level but was not statistically significant. Detailed results as following: 1) Serum 25(OH)D level in Diet group at 9th month was significantly increased compared to Waitlist group (p=0.0068) and Supplement group (p=0.0392), 2) Serum 25(OH)D in Diet group at 9th month was significantly increased compared to baseline (p=0.0166) and 3rd month (p=0.0268); 3) Serum 25(OH)D level in Sun exposure group at 3rd month and in Supplement group at 9th month was significantly increased compared to their baseline (p=0.0361 and p=0.0319); 4) HbA1c level in Diet group (p=0.0279) at 9th month was significantly reduced compared to Waitlist group, 5) HbA1c level in Diet group (p=0.0039) and Supplement Group (p=0.0332) at 3rd month and Diet group (p=0.0299) at 9th month also presented significant decreases compared to baseline, 6) Lipids levels were not significantly changed by the interventions. 𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻: Dietary vitamin D is the most effective source to increase Serum 25(OH)D levels and improve glycaemic control among T2DM patients. Vitamin D from sun and supplements requires a large dosage and a medium to long intervention time to show the effects. Future well-designed clinical trials should assess the vitamin D from natural lifestyle interventions to distinguish vitamin D’s effect on glycaemic control from the confounding factors and generate feasible and patient-oriented suggestions.

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